Arterial blood gas and acid base disbalance in intracranial hemorrhage / Монголын Анагаах Ухаан

ABSTRACT

Introduction. Approximately fifteen million people worldwide have a stroke each year. 1in 6 people around the world will have a stroke in their life time. Two-thirds of stroke deaths occur in less developed countries. PH is format used to describe the proton concentration in a solution. It is the negative logarithm10 of the H+ concentration, so when the blood pH is normal (7.35-7.45) the H+ concentration in the blood is 40 nmol.L. An acid is a substance that has the ability to give up a proton(H+-a positively charged hydrogen ion) and so when in an aqueous solution they have a low pH. A base is a substance that has the ability to accept a proton and has a high pH in solution. Respiratory alkalosis is results from the excessive excretion of CO2, and occurs when the PaCO2 is less than 4.5 kPa (34mmHg).Goal. To study and evaluate the change occurred in Glasgow coma scale and arterial blood gas, acid base balance of the patients suffering from intracranial stroke.Materials and Methods. Test for Arterial Blood Gas and Acid Base Balance were used on 112 patients with Intracranial Hemorrhage.Results. There were 66 men and 46 women between the ages of 25 and 83. Nineteen patients (17%) had normal, seventy seven (68.8%) patients had respiratory alkalosis, five patients (4.5%) had respiratory alkalosis and metabolic acidosis, two patients (1, 8%) had respiratory acidosis, four patients (3, 6%) had metabolic alkalosis, four patients (3.6%) had mixed alkalosis, and one patient (0.9%) had mixed acidosis. In cases of intracranial hemorrhage Arterial Blood Gas and Acid Base Balance is affected in most patients in the character of respiratory alkalosis and hypocapnia, due to hyperventilation. By Glasgow coma scoring system, twenty seven (24.1%) patients had 3 score, twenty eight (25%) patients had 4-8 score, twenty seven (24.1%) patients had 9-12 score, ten patients (8.9%) had 13-14 score, twenty (17.9%) patients had 15 score. In 3 score group 21 (77.8%) patients had respiratory alkalosis, 2 (7.4%) patients had respiratory acidosis, 1 patient had (3.7%)metabolic alkalosis, 1 (3.7%) patients had respiratory alkalosis and metabolic acidosis, 2 (7.4%) patients had mixed alkalosis, In 4-8 score group, 22 (78.6%) patients had respiratory alkalosis, 2 (7.1%) patients had normal, 2 (7.1%) patients had respiratory alkalosis and metabolic acidosis, 1 (3.6%) patient had mixed alkalosis, 1 (3.6) patient had mixed acidosis, In 9-12 score group, 24 (88.9%) patients had respiratory alkalosis, 1 (3.7%) patient had metabolic alkalosis, in 1 (3.7%) patient had respiratory alkalosis and metabolic acidosis, 1 (3.7%) patient had mixed alkalosis, In 13- 14 score group, 7 (70%) patients had respiratory alkalosis, 1 (10%) patient had metabolic alkalosis, 2 (20%) patients had normal, In15 score group, 3(15%) patients had respiratory alkalosis, 1 (5%) patient had metabolic alkalosis, 15 (75%) patient had normal, 1 (5%) patient had respiratory alkalosis and metabolic acidosis.Conclusion. There were significant correlations between Glasgow Coma Scale and acid base (r=0.45* p<0.001). Acid base disbalance more likely to get increased as much the Glasgow Coma Scale evaluation gets decreased.